tobramycin / dexamethasone
TobraDex (tobramycin / dexamethasone) is available as eye drops and an eye ointment. It's used to treat and relieve bacterial eye infections. This medication contains tobramycin (an aminoglycoside antibiotic that helps fight the infection) and dexamethasone (a corticosteroid that helps lower eye inflammation). Most people have few to no side effects from the medication when they use it as directed. But the medication can raise your eye pressure if you use it for more than 10 days.
What is TobraDex (tobramycin / dexamethasone)?
What is TobraDex (tobramycin / dexamethasone) used for?
- Eye inflammation from a bacterial infection in the eye
- Eye inflammation when there's a risk for a bacterial infection in the eye
How TobraDex (tobramycin / dexamethasone) works
TobraDex (tobramycin / dexamethasone) is a combination of two medications.
- Tobramycin is an aminoglycoside antibiotic. It kills bacteria by preventing them from making proteins that they need to survive.
- Dexamethasone is a corticosteroid. When it’s used in the eye, it lowers the amount of chemicals that cause pain, redness, and swelling there. This helps lower eye inflammation and relieve eye pain.
Drug facts
Side effects of TobraDex (tobramycin / dexamethasone)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Eye irritation
- Eye redness
- Itchy eyelids
- Swollen eyelids
Less Common Side Effects
- Eye pain
- Slow healing of the eye
TobraDex (tobramycin / dexamethasone) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Severe allergic reaction: swollen eyelids, redness, itching, rash, shortness of breath
- High eye pressure: eye pain when you move your eye or when you touch your eye
- Cataract: blurry vision, seeing double, seeing faded colors, can't see well at night, seeing halos around lights
The following TobraDex (tobramycin / dexamethasone) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of TobraDex (tobramycin / dexamethasone)
Pros
- Relieves eye inflammation and treats bacterial eye infection at the same time
- Combines two medications into one eye product for convenience
- Applied directly where the infection is (in the eye)
- Is safe and work wells for children as young as 2 years old
- Eye drops are available as a lower-cost generic
Cons
- Need to use multiple times a day
- Must shake the eye drop bottle before each use, which can be easy to forget
- Can cause eye irritation or allergic reactions for some people
- Requires an eye exam after 10 days of use to check your eye pressure
- Only treats some bacterial eye infections; it doesn't treat fungal or viral infections
Pharmacist tips for TobraDex (tobramycin / dexamethasone)
- Use TobraDex (tobramycin / dexamethasone) as directed by your prescriber. Don't stop using it before you complete treatment, even if your eye starts to get better. Your infection might come back or become harder to treat if you stop using the medication too early.
- Talk with your primary care provider if your eye inflammation or eye infection gets worse after you start using TobraDex (tobramycin / dexamethasone). You might need to get your eye checked out to see whether the medication is the most appropriate for your infection.
- Don't let the tip of the bottle or tube touch the eye, eyelid, or other surfaces. Don't touch the tip with your fingers. Otherwise, the medication can get contaminated. Using contaminated medication in the eye can cause serious harm, such as eye infection or vision loss.
- TobraDex (tobramycin / dexamethasone) can temporarily blur your vision. Don't drive a car or operate machinery until you know how this medication affects your vision and until you can see clearly.
- Remove any contact lenses from your eyes before each time you use TobraDex (tobramycin / dexamethasone). Some formulations of the medication contain a preservative called benzalkonium chloride. This preservative can get absorbed by soft contact lenses, which might affect how well the lenses work, fit, or feel on the eyes.
- In general, it's best not to wear contact lenses when you have an eye infection so that your infection doesn't get worse or your eye doesn't get even more irritated. Make sure to throw away the contact lenses you were wearing before you started using TobraDex (tobramycin / dexamethasone); they most likely have bacteria on them.
- Wash your hands with soap and water before and after each time you use TobraDex (tobramycin / dexamethasone). Discuss with your primary care provider or with your care team about other ways to help prevent your eye infection from getting worse and any new eye infections from popping up.
How to use TobraDex (tobramycin / dexamethasone) eye drops:
- Shake the bottle well before using. This makes sure the medication hasn’t settled at the bottom of the bottle.
- To use the eye drops, pull down your lower eyelid with one hand. Hold the bottle upside down just above the eye with the other hand. Gently squeeze the bottle to get the number of drops you need in your eye. Then, close your eye and press your finger to the corner of your eye closest to your nose for a minute. This helps the medication stay in your eye and prevents it from leaking into the nose.
- If you need to use another eye drop in the same eye, wait a few minutes so the second eye drop doesn't rinse off the first one.
How to use TobraDex (tobramycin / dexamethasone) eye ointment:
- Pull down your lower eyelid with one hand, and hold the tube of ointment with the other.
- Place a small amount (about one-half of an inch) of ointment in the space between your lower eyelid and eyeball. Briefly look down before you close your eye for a few minutes to help the medication reach all the necessary parts of the eye.
Common questions about TobraDex (tobramycin / dexamethasone)
No, TobraDex (tobramycin / dexamethasone) doesn't contain a penicillin. This combination medication contains a different kind of antibiotic called an aminoglycoside antibiotic (tobramycin) and a corticosteroid (dexamethasone). Since the medication doesn't contain penicillin or any antibiotics similar to penicillin, it's generally safe to use TobraDex (tobramycin / dexamethasone) if you have a penicillin allergy.
TobraDex (tobramycin / dexamethasone) is a combination medication that contains a steroid called dexamethasone. Since TobraDex (tobramycin / dexamethasone) is used in the eye only, its possible side effects are mostly related to the eye (such as eye irritation, eye redness, and itchy eyelids). Both TobraDex (tobramycin / dexamethasone) and other steroids that are taken by mouth have a risk for higher eye pressure and cataracts with long-term use. But TobraDex (tobramycin / dexamethasone) doesn't have other side effects that are normally tied to steroids, like stomach upset, trouble sleeping, and mood changes.
No, you won't be able to find or buy TobraDex (tobramycin / dexamethasone) over the counter. TobraDex (tobramycin / dexamethasone) is available by prescription from a healthcare professional only.
No, TobraDex (tobramycin / dexamethasone) is meant to be used for the eyes to treat eye inflammation and eye infection only. Don't use this medication in your ear to treat an ear infection. Ask your primary care provider about your treatment options if you have an ear infection. Some options include the "watch-and-wait" strategy or Ciprodex (ciprofloxacin / dexamethasone) ear drops.
Possibly. Styes typically go away on their own with warm compresses. But it's possible that you'll be prescribed TobraDex (tobramycin / dexamethasone) to help with the inflammation and the eye infection that's causing the stye if it doesn't go away after a week or if it gets worse. Don't use any leftover TobraDex (tobramycin / dexamethasone) that you might have at home for your stye — it might be contaminated or it might not be exactly right for this particular eye infection. Speak with a healthcare professional about your options if you're concerned about your stye.
Yes, TobraDex (tobramycin / dexamethasone) can expire. Look for the expiration date on the box that contains the medication, the eye drop bottle, or the tube of ointment. Don't use TobraDex (tobramycin / dexamethasone) if it's past this date. Medication that's past its expiration date might not work as well and might not be safe for you. Throw away the medication if it's expired. Ask your pharmacist if you're not sure whether your TobraDex (tobramycin / dexamethasone) has expired.
Use TobraDex (tobramycin / dexamethasone) for as long as your prescriber instructed you to (usually for 7 to 10 days). Antibiotic eye medications, such as TobraDex (tobramycin / dexamethasone), typically improve eye infections after you regularly use them for a few days. But be sure to use TobraDex (tobramycin / dexamethasone) for the full, prescribed length of treatment, even if your eye infection starts getting better. This makes sure that the infection is completely gone. Also keep in mind that using TobraDex (tobramycin / dexamethasone) for longer than 10 days can raise your risk for higher eye pressure and new eye infections. Ask your prescriber or pharmacist if you have questions about how long you should use this medication for your eye infection.
It's best to throw away any leftover TobraDex (tobramycin / dexamethasone) after your course of treatment. Don't keep it around to use later. Your eyes can get re-infected if you reuse the medication and it accidentally got contaminated with bacteria when you last used it. TobraDex (tobramycin / dexamethasone) also might not be the right medication to treat the type of eye infection you have next time. Each time you think you have an eye infection, you should see a healthcare professional to get your eye infection examined so you can be prescribed appropriate treatment.
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Risks and warnings for TobraDex (tobramycin / dexamethasone)
TobraDex (tobramycin / dexamethasone) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Only use on the surface of the eye
Use TobraDex (tobramycin / dexamethasone) on the surface of the eye only. Don't put TobraDex (tobramycin / dexamethasone) in your mouth, nose, or other parts of your body. Also don't use the medication as an injection into any parts of the eye.
Higher eye pressure
- Risk factors: Using TobraDex (tobramycin / dexamethasone) for more than 10 days | History of glaucoma
Using eye medications containing steroids long term can cause your eye pressure to go up. This can damage the eye and cause vision problems. Talk with your prescriber about the risks and benefits of using TobraDex (tobramycin / dexamethasone) if you already have glaucoma or high eye pressure.
Your prescriber might recommend that you go to your optometrist's office for an eye exam to check your eye pressure and make sure that TobraDex (tobramycin / dexamethasone) is safe for you. Your prescriber is more likely to suggest an eye exam if you need to use this medication for more than 10 days.
People don't typically have noticeable symptoms when their eye pressure is high, but some might feel pain when they move their eye around or when they touch the eye. Talk with your primary care provider or optometrist right away if you have eye pain or any vision problems while you're using TobraDex (tobramycin / dexamethasone).
New or worsened eye infections
- Risk factors: Using TobraDex (tobramycin / dexamethasone) for more than 10 days
Using TobraDex (tobramycin / dexamethasone) long term can raise the risk of developing other eye infections, such as fungal or bacterial eye infections. Don't use TobraDex (tobramycin / dexamethasone) if you have a viral eye infection because it can make your infection worse. Contact your primary care provider or urgent care if you have eye pain or redness, blurry vision, sensitivity to bright light, or watery discharge from your eye. Also call them if your symptoms don't improve after a couple days of treatment. These can be signs of a new eye infection that needs to be examined.
New eye problems (e.g., injury, cataracts)
- Risk factors: History of cataract | Using TobraDex (tobramycin / dexamethasone) for more than 10 days
In certain cases, using TobraDex (tobramycin / dexamethasone) might cause your cornea (the clear, outer layer of the eye) or the "whites" of the eye to thin. Sometimes, this can lead to eye damage. In addition, using TobraDex (tobramycin / dexamethasone) for a long period of time can cause cataracts (clouding of eye lens) to form. Seek medical attention right away if you have vision loss, blurry vision, or eye pain or if your eye is more watery than usual.
Using TobraDex (tobramycin / dexamethasone) after a cataract surgery might also slow down the healing process and raise the risk of fluid buildup in the eye. Talk with your eye surgeon right away if you’ve just had cataract surgery and you're having eye or vision problems.
Possible allergic reaction
Before you're prescribed TobraDex (tobramycin / dexamethasone), tell your primary care provider or a member of the urgent care team if you've had an allergy to similar antibiotics, such as gentamicin (Gentak). It's possible that you could have an allergic reaction to TobraDex (tobramycin / dexamethasone), too.
In general, watch out for signs and symptoms of allergic reactions, such as swollen eyelids, red or itchy eyes, or skin rash. Stop using TobraDex (tobramycin / dexamethasone) and call your primary care provider if you have an allergic reaction. These reactions often go away on their own once you stop the medication.
You might also be allergic to TobraDex (tobramycin / dexamethasone) if your eye infection doesn't get better after you start using the medication. Contact your primary care provider if your eye infection doesn't improve after a couple days of using the medication.
TobraDex (tobramycin / dexamethasone) dosage
Eye dropper| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 5ml of 0.3%/0.1% | 1 eye dropper | $28.07 | $28.07 |
| 2.5ml of 0.3%/0.1% | 1 eye dropper | $16.63 | $16.63 |
| 10ml of 0.3%/0.1% | 1 eye dropper | $43.78 | $43.78 |
Typical dosage for TobraDex (tobramycin / dexamethasone)
Eye drops
- TobraDex and generic tobramycin/dexamethasone: The eye drops contain 0.3% of tobramycin and 0.1% of dexamethasone. The typical dose is 1 or 2 drops in the affected eye(s) every 4 to 6 hours.
- TobraDex ST: The eye drops contain 0.3% of tobramycin and 0.05% of dexamethasone. The typical dose is 1 drop in the affected eye(s) every 4 to 6 hours.
- Depending on how serious your eye infection is and how severe your symptoms are, your prescriber might ask you to use the eye drops more often (every 2 hours) during the first 2 days of treatment.
Eye ointment
- TobraDex: The eye ointment contains 0.3% of tobramycin and 0.1% of dexamethasone. The typical dose is one-half of an inch of ointment in the affected eye(s) up to 3 or 4 times a day.
Interactions between TobraDex (tobramycin / dexamethasone) and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Artemether
- Ataluren
- Desmopressin
- Praziquantel
- Rilpivirine
- Rotavirus Vaccine, Live
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Abametapir
- Aceclofenac
- Acemetacin
- Alcuronium
- Aldesleukin
- Alfentanil
- Amiodarone
- Amtolmetin Guacil
- Apalutamide
- Atracurium
- Balofloxacin
- Bemiparin
- Benzhydrocodone
- Besifloxacin
- Boceprevir
- Bromfenac
- Bufexamac
- Buprenorphine
- Bupropion
- Carbamazepine
- Celecoxib
- Ceritinib
- Cholera Vaccine, Live
- Cholestyramine
- Choline Salicylate
- Cidofovir
- Ciprofloxacin
- Cisatracurium
- Clarithromycin
- Clonixin
- Cobicistat
- Codeine
- Colistimethate Sodium
- Conivaptan
- Daclatasvir
- Darunavir
- Decamethonium
- Desogestrel
- Dexibuprofen
- Dexketoprofen
- Diclofenac
- Dienogest
- Diflunisal
- Dihydrocodeine
- Dipyrone
- Doxacurium
- Doxorubicin
- Doxorubicin Hydrochloride Liposome
- Dronedarone
- Drospirenone
- Droxicam
- Efavirenz
- Elvitegravir
- Enoxacin
- Enzalutamide
- Estradiol
- Ethacrynic Acid
- Ethinyl Estradiol
- Ethynodiol
- Etodolac
- Etofenamate
- Etonogestrel
- Etoricoxib
- Etravirine
- Fazadinium
- Felbinac
- Fenoprofen
- Fentanyl
- Fepradinol
- Feprazone
- Fleroxacin
- Floctafenine
- Flufenamic Acid
- Flumequine
- Flurbiprofen
- Fosamprenavir
- Foscarnet
- Fosphenytoin
- Furosemide
- Gallamine
- Gatifloxacin
- Gemifloxacin
- Gestodene
- Hemin
- Hexafluorenium
- Hydrocodone
- Ibuprofen
- Idelalisib
- Indinavir
- Indomethacin
- Itraconazole
- Ixabepilone
- Ketoconazole
- Ketoprofen
- Ketorolac
- Lapatinib
- Levofloxacin
- Levonorgestrel
- Lomefloxacin
- Lopinavir
- Lornoxicam
- Loxoprofen
- Lumacaftor
- Lumateperone
- Lumiracoxib
- Lutetium Lu 177 Dotatate
- Lysine
- Macimorelin
- Mannitol
- Meclofenamate
- Medroxyprogesterone
- Mefenamic Acid
- Meloxicam
- Meperidine
- Mestranol
- Methadone
- Metocurine
- Mitotane
- Mivacurium
- Morniflumate
- Moxifloxacin
- Nabumetone
- Nadifloxacin
- Nadroparin
- Naproxen
- Nefazodone
- Nelfinavir
- Nepafenac
- Nevirapine
- Nifedipine
- Niflumic Acid
- Nilotinib
- Nimesulide
- Nimesulide Beta Cyclodextrin
- Nimodipine
- Nomegestrol
- Norelgestromin
- Norethindrone
- Norfloxacin
- Norgestimate
- Norgestrel
- Ofloxacin
- Oxaprozin
- Oxycodone
- Oxyphenbutazone
- Pancuronium
- Parecoxib
- Pazufloxacin
- Pefloxacin
- Pentazocine
- Phenylbutazone
- Phenytoin
- Piketoprofen
- Pipecuronium
- Piperaquine
- Piroxicam
- Posaconazole
- Pranoprofen
- Proglumetacin
- Propyphenazone
- Proquazone
- Prulifloxacin
- Rapacuronium
- Rifampin
- Ritonavir
- Rocuronium
- Rofecoxib
- Rufloxacin
- Salicylic Acid
- Salsalate
- Saquinavir
- Sargramostim
- Segesterone
- Sodium Salicylate
- Sparfloxacin
- St John's Wort
- Succinylcholine
- Sufentanil
- Sulindac
- Sunitinib
- Tacrolimus
- Telaprevir
- Telithromycin
- Tenoxicam
- Thalidomide
- Tiaprofenic Acid
- Tolfenamic Acid
- Tolmetin
- Tosufloxacin
- Tramadol
- Tubocurarine
- Ubrogepant
- Ulipristal
- Valdecoxib
- Vancomycin
- Vecuronium
- Velpatasvir
- Vincristine Sulfate Liposome
- Voriconazole
- Vortioxetine
- Voxilaprevir
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Alcuronium
- Aminoglutethimide
- Aprepitant
- Aspirin
- Atracurium
- Auranofin
- Caspofungin
- Cisplatin
- Cyclosporine
- Fluindione
- Fosaprepitant
- Fosnetupitant
- Gallamine
- Hexafluorenium
- Licorice
- Metocurine
- Netupitant
- Ospemifene
- Pancuronium
- Phenobarbital
- Rifapentine
- Saiboku-To
- Vecuronium
- Warfarin
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TobraDex (tobramycin / dexamethasone) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because TobraDex (tobramycin / dexamethasone) will not be safe for you to take.
- Eye infections caused by viruses, such as varicella (from chickenpox or shingles) or herpes
- Mycobacterial or fungal eye infections
What are alternatives to TobraDex (tobramycin / dexamethasone)?
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